CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: Goshen Hospital

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 77067
  • Insurance Median: $113
  • Cash Discount Price: $275
  • vs. Medicare Baseline: 0.90x Medicare
The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at Goshen Hospital is $113. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $275. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 0.90x the Medicare baseline. Located in 200 High Park Ave, Goshen, IN.
Cash / Self-Pay
$275

Average discount available for prompt cash payment at this facility.

Insurance Median
$113

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$126.25

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $126.25 (100%)
Cash / Self-Pay: $275 (218%)
Insurance Median: $113 (90%)
Cash: $275 (218% of Medicare)
Ins. Median: $113 (90% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $126.25 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Advantage Health Solutions $113 90%
Aetna $113 90%
Atrio Health Plans $113 90%
Bc Federal Employee $113 90%
Bc Mcr Advantage Ppo $113 90%
Blue Cross Blue Shield $113 90%
Buckeye Health Plan $113 90%
Cigna $113 90%
Coventry Health And Life $113 90%
Emblem Health $113 90%
Freedom Healthcare $113 90%
Geisinger Health Plan $113 90%
Health First $113 90%
Healthspring $113 90%
Humana $113 90%
Iehp Empire Health Plan $113 90%
Independent Care Health Plan $113 90%
Kaiser Permanente $113 90%
Mcr Advantra Freedom $113 90%
Mcr Allwell Mhs $113 90%
Mcr Banner Health $113 90%
Mcr Complete $113 90%
Mcr Complete Ppo $113 90%
Mcr Complete Wellmed $113 90%
Mcr Health Alliance $113 90%
Mcr Health Partners Plans $113 90%
Mcr Medical Mutual Of Ohio $113 90%
Mcr Passport Advantage $113 90%
Mcr Secure Horizons Ppo $113 90%
Mcr Texan Plus $113 90%
Mcr Upmc For Life $113 90%
Medicare (plans) $113 - $120 90%
Meridian Complete $113 90%
Optimum Healthcare $113 90%
Paramount Elite $113 90%
Primetime Health Plan $113 90%
Simply Complete Hmo $113 90%
The Umwa H&R Funds $113 90%
Todays Options Pyramid Life $113 90%
Trillium Advantage $113 90%
Ucare For Seniors $113 90%
Ucare Minnesota $113 90%
UnitedHealthcare $113 - $250 90%
Wellcare $113 90%
Champva $116 92%
Tricare $116 92%
Mcr Devoted Health Plan $120 95%
Mcr Provider Partners Hlth Pln $128 101%
Ambetter / Centene $162 128%
Mkt Caresource $162 128%
All Savers $250 198%
Golden Rule Insurance 2Nd $250 198%
Oxford Health $250 198%
Uhclic $250 198%
Uhss $250 198%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 200 High Park Ave, Goshen, IN 46526
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals